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ACCIDENTAL   CAUSES                                                  353

9.    Erythroblastosis Foetalis.When an En-negative woman is carrying
an Rh-positive foetus, anti-Rh agglutinins are formed in her serum owing to
the introduction of the Rh agglutinogen inherited by the foetus from the
Rh-positive father into her circulation through the placenta.    On passing
back into the foetal circulation through the placenta, these agglutinins cause
haemolysis of the red blood corpuscles of the foetus in the uterus.   Such a
hsemolytic process results in the group of conditions, known as   (1)  foetal
hydrops with still-birth, and (2) icterus gravis neonatorum and (3) anaemia
of the new-born, which generally cause the death of the foetus shortly after
birth.   It may be remarked that such cases are very rare in India.


Accidents causing the death of the child may occur during or after

birth/ ~"

During   Birth.1. ^Prolonged   Labour.Prolonged   labour   may   cause

the deaEE of a child by^ausing extravasation of blood into the meninges or

on the brain substance with or without fracture of the skuU bones owing to

severe compression of the head against the pelvis.   In a case where there is

fracture of the skull, it is usually a slight fissure of the parietal and frontal

bones or  a  spoon-shaped depression without any  external  injury on the

scalp.   The head will show a marked caput succedaneum and moulding as a

result of difficult labour.   In this connection it should be borne in mind that

the defective ossification of the cranial bones of a newly-born child may be

confounded with fractures which may lead to dangerous mistakes.    Casper ia

states that defective or retarded ossification commonly occurs in the frontal

and parietal bones and rarely in the occipital bone of mature as well as

immature  children.   He  describes  their  characteristic  appearances in the

following terms :    "If the bone in question is held up to the light this is

seen to shine through the opening, which is closed only by the pericranium.

When the periosteal membrane is removed, the deficiency in the ossification

is seen in the form of a round, or irregular opening, not often more than

three lines in diameter, though frequently less; its edges are irregular and

serrated; these edges arfe never depressed as is the case in fractures, and

neither they nor the parts in their neighbourhood are ever observed to be

ecehymosed."    Sometinfes,  the child dies from exhaustion  on account  of

prolonged and difficult Jabfrur.

2. Pressure on, ^Prolapse of, the Cord.-^^^jcli.cases, death occurs
from asphyxia and, okv post-mortem examination, blood, meeonium, liquor
amnii, or vernix caseosa may be found in the bronchial tubes. These may
be examined with a hand lens, or vernix caseosa may be stained with gentian
and violet solution, and then examined under the low power of a microscope.

3._JBaiQts of the Cord or its Twisting round the Neck.-^^ child is
sometimes strangled before birth by the knots or loops of tHe cord being
tightened, or the cord being coiled round its neck during delivery. A
spasmodic contraction of the os uteri round the neck of the child may result
in its death by suffocation.

^4.^J[n3uries.-^^^g^&-blows on the abdomen of a pregnant woman with
T>lunt weapons, kicks or falls from a height may kill the foetus in utero by
causing concussion of the brain with or without fracture of the skull boaaes
or rupture of the blood vessels or internal organs. In such cases it is aot
necessary that there should be any external marks of injuries oa Ifae
woman's abdomen. Sometimes, fractures of the long bones are <3ag^|^,;J^f\
infra-uterine injuries and are recognized by the formation of caS&$X

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10.   Forens. Med., Vol. IH, Eng. TransU HP- 119, 120.                                 , |,> ,

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